Medicare Your Coverage Options

Why traditional Medicare remains so popular

Written by Diane Archer

Uwe Reinhardt, PhD, writes Why Many Medicare Beneficiaries Cling to an Allegedly Worse Deal in JAMA Forum earlier this month. In a nutshell, he argues that traditional Medicare remains so popular because it offers people the choice of doctors and hospitals they want.

Reinhardt points out that the government spends more per person for Medicare Advantage enrollees (people enrolled in a commercial insurance plan that offers Medicare benefits) than on traditional Medicare. In addition, because Medicare Advantage plans generally rely on networks that restrict access to doctors and hospitals, they can offer seemingly more benefits and lower out-of-pocket costs to their enrollees than are available to people in traditional Medicare. But, still only 3 in 10 people with Medicare choose to enroll in one of these plans.

Most older adults, says Reinhardt, like the freedom of choice available through traditional Medicare exclusively. People value the ability to see almost any doctor and use virtually all hospitals and other health care facilities anywhere in the country. Indeed, the U.S. Government Accountability Office issued a report in September 2015 addressing concerns raised about the narrow networks in many Medicare Advantage plans that can limit access to needed care.  It recommended greater oversight of these plans.

Reinhardt also posits that people trust the government more than the commercial Medicare Advantage plans. People value traditional Medicare for the same reason they value Social Security–it is “an always faithful and reliable companion.” In sharp contrast the commercial insurers that offer Medicare Advantage are nothing more than “ephemeral companions.”

Medicare Advantage plans can morph and change at any time. The insurer who offers the Medicare Advantage plan can change many terms of the agreement whenever it wishes. Doctors and hospitals can move in and out of the network throughout the year, changing the network and undermining continuity of care. And benefits, copays and deductibles can change from year to year. Protocols for accessing care can also change. In addition, the Medicare Advantage plan can stop offering coverage altogether or the insurer offering the coverage could be bought by another insurer who changes the rules.

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